• Dean Hawley


This chapter outlines the policies and procedures for conduction of hospital autopsies. The described policies and procedures are intended to be compliant with the College of American Pathologists Laboratory Accreditation Program and the ACGME Residency Review Committee requirements for training programs. The chapter contains an explanation of the process for determining involvement with medical–legal authorities. There is a list of standard criteria for establishing validity of the informed consent, followed by procedures for review of the medical history, and determination of need for ancillary clinical laboratory testing. The autopsy procedure is covered from beginning to end, with dissection techniques for removing the organs, examining the organs, and submitting histologic blocks. The discussion includes suggestions for descriptive terminology of gross autopsy findings, with emphasis on describing findings that are in the body before removing the organs. The chapter concludes with a discussion of the final autopsy report, death certificate, and RRC Case Log.


Accreditation Council for Graduate Medical Education Alcoholism Aortic dissection Autopsy conference Autopsy restrictions Basilar skull fracture Block excision Cause of death Collage of American Pathologists Complete autopsy Death certificate Decomposition Effusions Endocardium Epicardium Exudates Heart valves Hemorrhages Informed consent Laboratory Accreditation Program Manner of death Next-of-kin Organ donation Organ retention Partial autopsy Patient-controlled anesthesia Prion Putrefaction Residency Review Committee Rokitansky method RRC Case Log System Subarachnoid hemorrhage Thromboembolism Tissue donation Toxicology Virchow method 

Suggested Reading

General References

  1. Clark SC, Ernst MF, Haglund WD, Jentzen FM, eds. Medicolegal Death Investigator: A Systematic Training Program for the Professional Death Investigator. Big Rapids, MI: Occupational Research and Assessment (for the National Association of Medical Examiners); 1996.Google Scholar
  2. Collins KA, Hutchins GM, eds. Autopsy Performance and Reporting. 2nd ed. Northfield, IL: College of American Pathologists;2003.Google Scholar
  3. Diagrams of body topography, organ systems, and individual organs are publicly available from the Office of the Armed Forces Medical Examiner (OAFME), through the web site for the Armed Forces Medical Examiner Service (AFMES) at the Armed Forces Institute of Pathology (AFIP), accessed at:
  4. Finkbeiner WE, Ursell PC, Davis RL, eds. Autopsy Pathology: A Manual and Atlas. Philadelphia, PA: Churchill Livingstone;2004.Google Scholar
  5. Gilbert-Barness E, Kapur R, Oligny LL, Siebert J, eds. Potter’s Pathology of the Fetur, Infant and Child. 2nd ed. St. Louis, MO: Mosby (Elseview B.V.);2007.Google Scholar
  6. Gorina Y, Lentzner H . Multiple causes of death in old age. Aging Trends, February 2008, Centers for Disease Control and Prevention, National Center for Health Statistics, U.S. Dept. of Health and Human Services, accessed at
  7. Gray F, De Girolami U, Poirier J, eds. Escourelle and Poirier’s Manual of Basic Neuropathology. 4th ed. Oxford, UK: Butterworth-Heinemann (Elsevier Science);2003.Google Scholar
  8. Hoyert DL, Kung HC, Xu J, and the Division of Vital Statistics: Autopsy ­patterns in 2003: Data on mortality. Centers for Disease Control and Prevention, National Center for Health Statistics, U.S. Dept. of Health and Human Services, 2007, series 20, number 32, DHHS publ. no. (PHS) 2007-1851.Google Scholar
  9. Ludwig J, ed. Handbook of Autopsy Practice. 3rd ed. Totowa, NJ: Humana Press;2002.Google Scholar
  10. National Association of Medical Examiners: Policy and Guidelines on Human Organ and Tissue Procurement, 2002 Aug., accessed at Position Papers,
  11. The Laboratory Accreditation requirements for autopsy services are from the College of American Pathologists, Commission on Laboratory Accreditation, Laboratory Accreditation Program, Anatomic Pathology Checklist, accessed at
  12. The Residency Review Committee requirements for autopsy service are from the Residency Review Committee (RRC) of the Accreditation Council for Graduate Medical Education accessed at

Journal Articles

  1. College of American Pathologists Conference XXIX: Restructuring Autopsy Practice for Health Care Reform. A compendium of articles from the May 1995 Conference, Arch Pathol Lab Med 1996; 120:693–785.Google Scholar
  2. Ironside JW, Bell JE. The “high-risk” neuropathological autopsy in AIDS and Creutzfeldt–Jacob disease: principles and practice. Neuropathol Appl Neurobiol 1996; 22:388–393.PubMedCrossRefGoogle Scholar
  3. National Guidelines for Death Investigation, by the National Medicolegal Review Panel, 1997 Dec, National Institute of Justice, Office of Justice Programs, U.S. Dept. of Justice, publ. no. NCJ 167568, available at
  4. Powers JM and the Autopsy Committee of the College of American Pathologists: Practice guidelines for autopsy pathology: Autopsy procedures for brain, spinal cord, and neuromuscular system. Arch Pathol Lab Med 1995; 119:777–783.PubMedGoogle Scholar
  5. Randall BB, Fierro MF, Froede RC, and the Forensic Pathology Committee of the College of American Pathologists: Practice guidelines for forensic pathology. Arch Pathol Lab Med 1998; 122:1056–1064.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Dean Hawley
    • 1
  1. 1.Indiana University School of MedicineIndianapolisUSA

Personalised recommendations